Objective To investigate the role of arcuate fasciculus in conduction aphasia after ischemic stroke using magnetic resonance diffusion tensor imaging (DTI) technique. Methods Five patients with conduction aphasia after acute ischemic stroke (case group) and 5 patients without aphasia (control group) were selected. The DTI technique was used to detect the fractional anisotropy (FA) of Broca's area, Wernicke's area, and arcuate fasciculus. Results The FA values of Broca's area (0. 341 ± 0. 018 vs. 0. 295 ± 0. 060; t = 4. 533, P = 0. 045), Wernicke's area (0. 303 ± 0. 009 vs. 0. 243 ± 0. 011; t = 6. 556, P = 0. 022), and arcuate fiber bundle (0. 646 ± 0. 020 vs. 0. 541 ± 0. 009; t = 7. 343, P = 0. 018) in the left hemisphere were significantly higher compared with their mirror areas in the control group. The FA values of Broca's area (0. 315 ± 0. 015 vs. 0. 280 ± 0. 006; t = 6. 246, P = 0. 023), Wernicke's area (0. 299 ± 0. 012 vs. 0. 239 ± 0. 022; t = 4. 576, P = 0. 025), and arcuate fiber bundle (0. 226 ± 0. 016 vs. 0. 294 ± 0. 007; t = - 12. 590, P = 0. 006) in the left hemisphere were significantly higher compared with their mirror areas in the case group. There was no significant difference Broca's area (t = 1. 901, P = 0. 13) and Wernicke's area (t =2. 092, P = 0. 105) in the left hemisphere between the case group and the control group, but the FA values of arcuate fasciculus in the left hemisphere in the case group was significantly lower compared with the control group (t = 28. 393, P < 0. 001 ). Conclusions For patients with conduction aphasia after acute ischemic stroke, the arcuate fasciculus has the left-dominant lateralization. Their conduction aphasia may be associated with the reduction and break of the arcuate fasciculus.

Since its founding,the Management Center of Shenzhen Public Hospitals,on the basis of summarizing and inheriting reform outcomes in the past,has been working on to streamline the relationship between the government,public hospitals and the society in line with the general reform requirements of the stateupholding public welfare nature,motivating and ensuring sustainability.The center carries out a general reform covering the hospital management system,operating mechanism,supervision mode,and service mode.This way the center has built a set of contemporary hospital management system fitting Shenzhen' s conditions,encouraging hospital operations to better embody the interests of the government,medical workers and the society,and to better cover quality,equity and efficiency,thus effectively improving the management performance and services of the hospitals in question.

Analysis of setbacks found in the existing system and mechanism of public hospitals. Based on the health reform principles of Separation of administration and management, Separation of administration and operation, Separation of prescribing and dispensing, and Separation of for-profit hospitals and nonprofit hospitals, the authors named the following roadmap for public hospital governance reform. First, set up a management committee for each public hospital to coordinate the government function for medical service; set up a public hospital authority to upgrade the management level of these hospitals; transform functionality of health authorities to encourage diversity in medical service providers. Second, establish the tiered decision making mechanism, autonomous operation system and diversified supervision system, to separate administration and management. Third, formulate articles of association for hospitals to encourage their evolution to legal entities, consolidating the government reforms by legal means.

Objective To investigate the autonomic nervous system function of hyperthyroidism and hyperthyroidism by analyzing the heart rate variability of patients with the diseases. Methods 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used in 36 patients with hyperthyroidism, 30 patients with hypothyroidism and 26 cases of healthy volunteers(controls), and 24-hour electrocardiogram was analyzed.Heart rate variability indicators observed included 24 h consecutive sinus standard deviation of R-R interval (SDNN), standard deviation of sequential five-minute R-R interval (SDANN), percentage of differences between adjacent NN intervals that ＞ 50 ms(PNN50), root mean square standard deviation from adjacent R-R interval (rMSSD), low-frequency power (LF), high frequency power (HF), low frequency power/high frequency power (LF/HF). Results In hyperthyroidism group, SDNN[(80.48 ± 11.95)ms], PNN50[(18.56 ± 3.50)%], rMSSD [ ( 13.56 ± 3.45)ms] were significantly lower than those of the control group[ ( 128.06 ± 12.8)ms, (32.84 ± 7.21)%,(30.84 ± 6.12)ms, all P ＜ 0.05 ], and LF/HF(3.78 ± 1.63) were significantly higher than that of the control group (2.34 ± 1.06, P ＜ 0.05). In hypothyroidism group, SDNN[(65.65 ± 15.55)ms], SDAN[ (80.2 ± 15.72)ms],PNN50[ (16.34 ± 3.56)%], rMSSD [ (15.77 ± 3.58)ms ], LF[ (279.03 ± 91.49)ms2/Hz ] were also significantly lower than those of the control group[ (128.06 ± 12.87)ms, (132.40 ± 21.95 )ms, (32.84 ± 7.21 )%, (30.84 ± 6.12)ms, (525.60 ± 84.11)ms2/Hz, all P ＜ 0.05], but LF/HF (1.08 ± 0.73) was lower than that of the control group,however, the difference was not significant(P ＞ 0.05). Conclusions The heart rate in patients with abnormal thyroid function is lower in the overall performance, but in patients with hyperthyroidism sympathetic activity is dominate, while in patients with hypothyroidism, vagal nerve activity is dominate.

Objective To observe the heart rate variability in patients with hypothyroidism, and to analyze the effect of 131Ⅰ therapy on autonomic nervous system of patients with the diseases. Methods A total of 56 cases of hyperthyroidism from the Second Affiliated Hospital of Harbin Medical University and the Second Hospital of Harbin City were enrolled as research subjects. 12-synchronous dynamic 24-hour monitoring and man-machine dialogue were used 6 months before and after 131Ⅰ treatment, and 49 cases of healthy volunteers were selected as controls.Heart rate variability indicators observed included 24 h consecutive sinus standard deviation of R-R interval (SDNN), standard deviation of sequential five-minute R-R interval (SDANN), percentage of differences between adjacent NN intervals that > 50 ms(PNN50), root mean square standard deviation from adjacent R-R interval (rMSSD), very low frequency power(VLF), low frequency power(LF), high frequency power(HF), and low frequency power/high frequency power(LF/HF). Results In hyperthyroidism group before 131Ⅰ therapy, SDNN[(85.25 ± 13.59)ms], SDANN [( 95.47 ± 33.15)ms], PNN50 [( 15.26 ± 4.84) %], rMSSD [( 14.47 ~ 3.49) ms], LF [(435.57 ± 75.74)ms2/Hz], and HF[(129.81 ± 63.21 )ms2/Hz] were significantly lower than those of the control group [(155.24 ±15.87), ( 134.02 ± 24.15)ms, (29.41 ± 6.21 )%, (26.64 ± 6.11 )ms, (515.69 ± 74.83)ms2/Hz, and (265.93 ± 58.84)ms2/Hz, all P < 0.05], VLF[(1765.21 ± 315.22)ms2] and LF/HF(3.95 ± 1.89) were significantly higher than that of the control group[(374.25 ± 54.47)ms2, 2.94 ± 1.55, all P < 0.05]. In hyperthyroidism group after treatment,SDNN [(126.91 ± 16.32)ms], SDANN[(125.2 ± 43.22)ms], PNN50[(26.34 ~ 7.56)%], rMSSD[(24.85 ± 7.85)ms],LF [(489.35 ± 91.49)ms2/Hz], and HF [(209.45 ± 75.32)ms] were also significantly higher than those before 131Ⅰ therapy, VLF[(571.80 ± 97.41)ms] and LF/HF(2.41 ± 0.93) were lower than that before 131Ⅰ therapy,but SDNN, PNN50 and HF were lower and VLF was higher than those of the control group (all P < 0.05). Conclusions The heart rate variability in patients with hyperthyroidism is lower in the overall performance, sympathetic activity is dominate, 131Ⅰ therapy partly corrects abnormal autonomic nerve function.

Objective To explore the relevance of safety culture in hospital nursing and the head nurse leadership behavior.Method The study adopts the method of convenience sampling to diversify the head nurse leadership behavior and nursing safety culture of 344 nurses in 3 first-class tertiary hospital of traditional Chinese Medicine in Heilongjiang Province.All survey data were entered into the SPSS17.0 software for analysis.Finally,conclusion was got.Result The head nurse leadership behavior is the highest score for leadership charm,followed by passive exception management,personalized care,active exception management,charisma,contingent reward and intellectual stimulation.Safety culture of nursing is slightly higher than medium level,in wh ch the team atmosphere,the satisfaction of the work,the unit security atmosphere,the management experience is higher than the medium level.The cognitive score of the pressure is lower than the medium level.Conclusion All dimensions of nurses' perception of head nurse leadership behavior has a positive correlation with each dimension of safety culture in hospital nursing.

OBJECTIVE:To observe therapeutic efficacy and safety of applying dexamethasone+docetaxel+cisplatin+fluoroura-cil(DCF)regimen induction chemotherapy before Ⅲ-Ⅳ stage oral squamous cell carcinoma resection. METHODS:A total of 120 patients with Ⅲ-Ⅳ stage oral squamous cell carcinoma were randomly divided into control group(60 cases)and observation group (60 cases). Both groups were given oral cancer resection,control group received radiotherapy 4-6 weeks after surgery,observation group was additionally given Dexamethasone acetate tablets 0.75 mg orally once a day,d1-7+Docetaxel injection 80 mg/m2 added in-to 0.9% Sodium chloride solution 250 mL intravenously for 2 h,d2+Cisplatin injection 80 mg/m2 added into 0.9% Sodium chloride solution 250 mL intravenously for 1 h,d2+Fluorouracil injection 750 mg/m2 added into 0.9% Sodium chloride solution 500 mL in-travenously,d2-5. Treatment course of 2 groups lasted for 7 d. Clinical efficacies of 2 groups were observed as well as EORTC QLQ-C30 score before and after treatment,recurrence rate 12,24,36 months and the occurrence of ADR. RESULTS:The short-term total response rate of observation group was significantly higher than that of control group;12,24,36 months fol-low-up recurrence rate of observation group were significant lower than those of control group;the incidence ofⅠ-Ⅱ degree nausea and vomiting,leucopenia in observation group were significantly higher than control group,with statistical significance (P<0.05);there was no statistical significance in the incidence of Ⅲ-Ⅳ degree nausea and vomiting,leucopenia andⅠ-Ⅱ,Ⅲ-Ⅳ de-gree diarrhea between 2 groups (P>0.05). Before treatment,there was no statistical significance in EORTC QLQ-C30 score be-tween 2 groups(P>0.05). After treatment,EORTC QLQ-C30 score of 2 groups were significantly lower than before,with statisti-cal significance (P<0.05),but there was no statistical significance between 2 groups (P>0.05). CONCLUSIONS:The applying of DCF regimen induction chemotherapy can improve short-term efficacy before Ⅲ-Ⅳ stage oral squamous cell carcinoma resec-tion,reduce reoccurrence risk but induce high incidence ofⅠ-Ⅱ degree nausea and vomiting,leucopenia.

Objective To investigate the effect of different ratios of ginsenosides(GS) and panax notoginsenosides(PNS),which are extracted from Qi-strengthening herbs of Radix Ginseng and blood-activating herbs of Radix Notoginseng respectively,on rats peritoneal mesothelial cells(PMCs) in peritoneal dialysis solution(PDS).Methods PMCs were isolated from rat peritoneal membrane by trypsin digestion method,and then a stable PMCs culture model was established.PMCs were pre-exposed in 4.25% PDS for 3 hours,and then respectively grew in culture solution with different ratios of GS or PNS for 6 hours.The capacity of proliferation of rat PMCs was assessed by methyl thiazolyl tetrazolium(MTT) assay.Results GS 100?g/mL and PNS 80?g/mL showed protective effect on the proliferation of injured PMCs in PDS(P 0.05).Conclusion The combination of GS and PNS,which are extracted from Qi-strengthening herbs of Radix Ginseng and blood-activating herbs of Radix Notoginseng respectively,exerts certain protective effect on PMCs in peritoneal dialysis solution.

Tumor markers of breast cancer are closely related to its biological behaviors and are essential for treatment strategy making. Although traditional immunohistocbemistry(IHC) is the most commonly used molecular pathological method for tumor marker detection, it can not meet the clinical requirements for quantitative and individualized treatment. With the unique photo-physical properties of quantum dots(QDs), QDs conjugated probes have been successfully used in molecular and in vivo imaging, in the study on mechanism of drug delivery and targeted therapy and especially in the detection of tumor markers in vitro and molecular targeted diagnosis of breast cancer and individualized treatment strategy making. The technique has a broad prospect in clinical application.

Objective To investigate the diagnostic value of CT-guided percutaneous biopsy of peritoneum for unknown ascites.Methods The clinical data of 106 cases of unknown peritoneum in our hospital were collected retrospectively over the past five years (May 23,2011 to August 2,2016).The sensitivity and specificity of the percutaneous biopsy of peritoneum in diagnosis of the patients with unknown etiological ascites were evaluated.Complications were collected to evaluate the safety.Results The 106 patients with unknown ascites were performed with CT-guided percutaneous biopsy of peritoneum.The diagnoses of 91 patients were confirmed pathologically,accounted for 85.85％ of the total.Among the 91 patients,there were 60 cases (56.60％) of malignant and 31 cases (29.25％) of benign.The other 15 patients had no clinical diagnosis,which accounted for 14.15％ of the total.The diagnostic sensitivity and specificity was 88.35％ and 100％ respectively,which were significantly superior to cytological examination,biochemical markers and other routine analysis.No severe complications were observed in all patients.Conclusion CT-guided percutaneous biopsy of peritoneum for unknown ascites plays an important instructive role in diagnosis with high accuracy,and it is a safe and effective method.